Because evaluation of most computerized decision support has been focused on whether the technology[unreadable] works, we still know little about why these systems succeed or fail. For instance, despite computerized[unreadable] reminders for hypertension management in one of the nation?s largest healthcare systems, 22% of[unreadable] hypertensive patients in that system have not met basic blood pressure goals.[unreadable] This project proposes to study a new technology called the Integrated Medication Manager. This application[unreadable] was developed using well-established theories of cognition, notably Hollnagel?s Contextual Control Theory. It is[unreadable] designed to facilitate improved decision-making by helping clinicians to consider more relevant data and to[unreadable] better plan patient care. One of the major features of this system is the explicit linking of patient problems,[unreadable] therapies, and goals.[unreadable] This project will compare the new Integrated Medication Manager to the current version of the Veterans[unreadable] Administration?s Computerized Patient Record System (CPRS).[unreadable] Specific aims are:[unreadable] Aim 1. Identify cognitive components of providers? therapeutic decision making in the field..[unreadable] Aim 2. Refine and evaluate the Integrated Medication Manager using simulation studies.[unreadable] Aim 1.a. Refine interfaces and logic of the Integrated Medication Manager.[unreadable] Aim 1.b. Compare the performance of the Integrated Medication Manager and usual CPRS.[unreadable] Aim 3. Implement and Evaluate the Integrated Medication Manager in a cluster-randomized trial.[unreadable] Aim 3.a. Assess differences in surrogate clinical endpoints such as blood pressure versus usual CPRS.[unreadable] Aim 3.b Evaluate provider satisfaction and adoption.